Pregnancy with ventricular arrhythmias

doi:10.3877/cma.j.issn.2095-3259.2022.01.003

Abstract

Abstract:

Ventricular arrhythmias is the most common cardiovascular disease in pregnancy with and without structural heart diseases, which could cause unstable hemodynamics and then lead to adverse maternal and neonatal outcomes. Owing to the complex etiology of ventricular arrhythmias, a multidisciplinary care approach with obstetrics, cardiology, anesthesiology and neonatology is required. Optimal individual management of ventricular arrhythmias in pregnancy is crucial for the safety of mother and fetus. In this study, we discussed the type, treatment and management of ventricular arrhythmias. Furthermore, we emphasized that multidisciplinary collaborative management to the prognosis of ventricular arrhythmias in pregnancy.

Key words: Arrhythmia, cardiac, Pregnancy complication, Diagnosis, Treatment

Caixia Zhu, Zilian Wang. Pregnancy with ventricular arrhythmias[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2022, 11(01): 8-12.

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URL: https://zhckjjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3259.2022.01.003

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References 18

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药物分类	常用药物	作用特点	适应证	用药方法及剂量
Ⅰb类	利多卡因	钠离子通道阻滞剂	室性期前收缩、室性心动过速、长QT综合征、室颤	负荷量1~1.5 mg/kg，2~3 min内静注，间隔5~10 min可重复，最大3 mg/kg，维持量1~4 mg/min
Ⅰc类	普罗帕酮	钠离子通道阻滞	妊娠期研究有限，谨慎使用	—
Ⅱ类	美托洛尔	β受体阻滞剂	室性期前收缩、室性心动过速	首剂5 mg，5 min静注，间隔5~15 min可重复，最大量10~15 mg(0.2 mg/kg)
Ⅲ类	索他洛尔、胺碘酮	钾离子通道阻滞剂	妊娠期研究有限，谨慎使用	—
Ⅳ类	维拉帕米	非二氢吡啶类钙离子通道阻滞剂	特发性室性心动过速	0.3~0.5 mg，>2 min缓慢静注；15~30 min可重复，最大量20~30 mg
其他	腺苷	激活乙酰胆碱敏感钾通道，降低自律性	室性心动过速	3~6 mg，快速静注，2 min后可予6~12 mg快速静注
	硫酸镁	细胞钠钾转运的辅助因子	伴有QT间期的多形性室性心动过速	负荷量1~2 g，15~20 min静注；维持量0.5~1.0 g/h静注

药物分类	常用药物	作用特点	适应证	用药方法及剂量
Ⅰb类	利多卡因	钠离子通道阻滞剂	室性期前收缩、室性心动过速、长QT综合征、室颤	负荷量1~1.5 mg/kg，2~3 min内静注，间隔5~10 min可重复，最大3 mg/kg，维持量1~4 mg/min
Ⅰc类	普罗帕酮	钠离子通道阻滞	妊娠期研究有限，谨慎使用	—
Ⅱ类	美托洛尔	β受体阻滞剂	室性期前收缩、室性心动过速	首剂5 mg，5 min静注，间隔5~15 min可重复，最大量10~15 mg(0.2 mg/kg)
Ⅲ类	索他洛尔、胺碘酮	钾离子通道阻滞剂	妊娠期研究有限，谨慎使用	—
Ⅳ类	维拉帕米	非二氢吡啶类钙离子通道阻滞剂	特发性室性心动过速	0.3~0.5 mg，>2 min缓慢静注；15~30 min可重复，最大量20~30 mg
其他	腺苷	激活乙酰胆碱敏感钾通道，降低自律性	室性心动过速	3~6 mg，快速静注，2 min后可予6~12 mg快速静注
	硫酸镁	细胞钠钾转运的辅助因子	伴有QT间期的多形性室性心动过速	负荷量1~2 g，15~20 min静注；维持量0.5~1.0 g/h静注

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